Confirmation of endotracheal intubation by ultrasonic sliding lungsign and auscultation in normal and overweight surgical patients: A Comparative Study

Airway management is a major responsibility of the anaesthesiologist. Difficulties with tracheal intubation significantly contribute to the morbidity and mortality assosiated with anaesthesia .Overweight and obese patients are predisposed to difficult airway and intubation in comparison to the non obese patients.According to WHO a person with BMI >25 is  considered overweight and a person with BMI>30 is considered obese.increased risk of hypoxemia  during the induction of anaesthesia in these patients could be  compounded by an increased time required for insertion of the tracheal tube,besides reduction in functional residual capacity and compliance with an increase in airway  resistance and pulmonary vascular resistance.most frequently used methods of confirmation of endotracheal  intubation are auscultation of chest and end tidal carbon dioxide  detection.obese patients usually yield confusing or misleading auscultatory findings as the sound waves have to traverse large amount of tissues  which represent a significant barrier. Intercostals ultrasonographic view at the lung  chest-wall interface, to and fro movement of the pleura synchronised with ventilation (lung sliding sign)is an accurate  indicatorof endotracheal intubation,and hence can be used as an additional measure for confirming prooper tracheal placement of the endotracheal tube .In our study we aim to assess  the time taken for confirming  ETT placement using ultrasonic sliding lung sign vs. auscultation method in normal and obese surgical patients.